Preventing adverse drug events remains a top resident safety priority not only in hospitals but also across all healthcare settings such as nursing homes and care homes. There are many reasons why medication errors occur and one of the most common reasons is caregivers not having accurate medication history of residents at care homes. Without an accurate medication history, doctors may inadvertently make incorrect decisions about a resident’s health. When caregivers accurately obtain a resident’s medication history, they can prevent medication errors such as omissions, duplications, dosing errors or drug interactions.
Here are some ways to take an accurate medication history:
- Consult the resident or resident’s family
A resident should always be consulted at the time of recording medication history. If a resident is not in a condition to furnish information (for instance, they are unconscious or have a learning disability), the resident’s family may be consulted instead. The information provided must always be confirmed by a second source like a previous caregiver or doctor.
- Note the use of herbal medicines and supplements
While interacting with residents or their families, information related to herbal supplements, dietary supplements and over-the-counter drugs should be obtained and duly noted. Often residents take herbal supplements without the knowledge of their doctors. These supplements may also cause ADRs or interact with medicines that doctors may prescribe in future. Although some residents may not consider these as medicines, the information regarding these medications is important for resident safety.
- Check the GP list of medications
The GP of residents can provide medicine lists and information on medicines. However, these lists only detail what the GP has prescribed the resident and this may not reflect what the resident is taking. When seeking medication information from the GP, it is appropriate to obtain a written copy of the medication summary. If a resident has recently been in hospital or received treatment, you will have to consult the hospital for more recent information.
- Previous discharge documents should be checked
Previous discharge documents may help if a resident has been discharged from the hospital recently. Do note any changes made to their medications since discharge from the hospital.
- Review MAR sheets from previous care homes
If a resident is moving into a new facility from a residential home, MAR sheets should be reviewed thoroughly. MAR sheets will help new caregivers identify medicines recently started, discontinued, refused or omitted. Extra caution should be taken to review paper-based MAR sheets as handwritten notes and changes can be either difficult to understand or can create confusion with regards to abbreviations or same sounding drugs.
When should medication history be reviewed?
Whenever there is a change in care in which new medications are prescribed or existing prescriptions are changed. Changes in care setting, service, or level of care warrant that medication documents be reviewed and updated.
Use electronic medication administration systems to record medication history
Many care homes in the UK use electronic medication administration systems such as eMAR to facilitate the process of medication order entry. A perfect alternative to existing paper-based MAR charts, eMAR help in documenting all current medicines prescribed to the residents. Not just that, eMAR allows caregivers to order medications and make notes regarding tests and procedures ordered by doctors, and provide other instructions related to the residents under their care.
How eMAR can help your care home reduce potential medication errors
- No scope of confusion due to illegible handwriting
- eMAR can be integrated with the pharmacy so no missed dosage due to inadequate stock.
- No missed dosage as real-time alerts notifies caregivers when medication is due.
- No communication gaps as caregivers, supervisors and other stakeholders can access electronic MAR sheets on a real-time basis and that too without being physically present in the care homes.
- No communication gaps due to missed signatures as the electronic system will alert continually when medicines have not been administered at the correct time.